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Eur Heart J. 2014 Feb;35(5):271-81. doi: 10.1093/eurheartj/eht406. Epub 2013 Oct 8.

High population prevalence of cardiac troponin I measured by a high-sensitivity assay and cardiovascular risk estimation: the MORGAM Biomarker Project Scottish Cohort.

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1
Clinic for General and Interventional Cardiology, University Heart Centre Hamburg, Hamburg, Germany.

Abstract

AIMS:

Our aim was to test the prediction and clinical applicability of high-sensitivity assayed troponin I for incident cardiovascular events in a general middle-aged European population.

METHODS AND RESULTS:

High-sensitivity assayed troponin I was measured in the Scottish Heart Health Extended Cohort (n = 15 340) with 2171 cardiovascular events (including acute coronary heart disease and probable ischaemic strokes), 714 coronary deaths (25% of all deaths), 1980 myocardial infarctions, and 797 strokes of all kinds during an average of 20 years follow-up. Detection rate above the limit of detection (LoD) was 74.8% in the overall population and 82.6% in men and 67.0% in women. Troponin I assayed by the high-sensitivity method was associated with future cardiovascular risk after full adjustment such as that individuals in the fourth category had 2.5 times the risk compared with those without detectable troponin I (P < 0.0001). These associations remained significant even for those individuals in whom levels of contemporary-sensitivity troponin I measures were not detectable. Addition of troponin I levels to clinical variables led to significant increases in risk prediction with significant improvement of the c-statistic (P < 0.0001) and net reclassification (P < 0.0001). A threshold of 4.7 pg/mL in women and 7.0 pg/mL in men is suggested to detect individuals at high risk for future cardiovascular events.

CONCLUSION:

Troponin I, measured with a high-sensitivity assay, is an independent predictor of cardiovascular events and might support selection of at risk individuals.

KEYWORDS:

Cardiovascular risk; High-sensitivity assayed troponin I; MONICA Risk Genetics Archiving and Monograph (MORGAM); Mortality; Scottish Heart Health Extended Cohort (SHHEC)

PMID:
24104876
DOI:
10.1093/eurheartj/eht406
[Indexed for MEDLINE]
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